Failure to Maintain Active Physician Orders for Dialysis
Penalty
Summary
The facility failed to maintain active physician orders for dialysis for two residents diagnosed with end stage kidney disease and other significant health conditions. Review of the clinical records showed that both residents were admitted with diagnoses including end stage kidney disease and diabetes mellitus, and their Minimum Data Set (MDS) assessments indicated they were receiving dialysis while residing in the facility. However, upon review of their physician orders, it was found that neither resident had an active order for dialysis at the time of the survey. This deficiency was confirmed during an interview with the Director of Nursing, who acknowledged that the physician orders for both residents did not include dialysis, despite documentation in the MDS that dialysis was being provided. The lack of active physician orders for dialysis was cited as a failure to provide safe and appropriate dialysis care and services, as required by state regulations.